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17516 Us Highway 59 Ste 110 New Caney TX 77357-8718 | |
| (832) 478-0200 | |
| (832) 376-7509 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 17516 Us Highway 59 Ste 110, New Caney, Texas |
| Authorized Official Name and Position | Vanessa Renee Larson (BILLING) |
| Authorized Official Contact | 4092911855 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
17516 Us Highway 59 Ste 110 New Caney TX 77357-8718 Ph: (832) 478-0200 | 17516 Us Highway 59 Ste 110 New Caney TX 77357-8718 Ph: (832) 478-0200 |
| NPI Number | 1699342261 |
|---|---|
| Provider Enumeration Date | 06/10/2021 |
| Last Update Date | 02/05/2025 |
| Medicare PECOS PAC ID | 2163810342 |
|---|---|
| Medicare Enrollment ID | O20211020000806 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699342261 | NPI | - | NPPES |
| 188605302 | Medicaid | TX | |
| 1994827865 | Other | TX | TRICARE SOUTH |
| 8CJ367 | Other | TX | BCBSTX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Kimberly D Petitt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194827865 PECOS PAC ID: 3779547120 Enrollment ID: I20070202000215 |
| Provider Name | Lourdes Ticas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184715674 PECOS PAC ID: 7416021290 Enrollment ID: I20080922000058 |
| Provider Name | Bonny Walter Ogar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700171014 PECOS PAC ID: 8527289644 Enrollment ID: I20141014002079 |
| Provider Name | Brenda F Steele |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588040398 PECOS PAC ID: 4284934621 Enrollment ID: I20151208000081 |
| Provider Name | Brenda Vasiljevich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417490798 PECOS PAC ID: 0042593907 Enrollment ID: I20170220001696 |
| Provider Name | Nina Fonteneaux |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407390693 PECOS PAC ID: 6709163470 Enrollment ID: I20170505001022 |
| Provider Name | Anupa Sharma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871017582 PECOS PAC ID: 8022380872 Enrollment ID: I20171114000275 |
| Provider Name | Soumaila Camara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356636476 PECOS PAC ID: 5991188492 Enrollment ID: I20220816002961 |
| Provider Name | Brittany Tralicia Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083306278 PECOS PAC ID: 7416306071 Enrollment ID: I20231208000829 |
West Fork Management And Consulting Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 20185 Us Highway 59 Ste 78b, New Caney, TX 77357 Phone: 832-543-5032 Fax: 281-913-0358 | |
Mddrip Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 21853 Lost Mdw, New Caney, TX 77357 Phone: 832-583-7264 | |
Classic Care Management, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 20185 Us Highway 59, Suite 78, New Caney, TX 77357 Phone: 713-569-0045 Fax: 281-399-5677 | |
Barry G Willens Md Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 20185 Us Highway 59, Suite 72, New Caney, TX 77357 Phone: 281-689-8144 Fax: 281-399-8904 | |
Magnolia Physician Services Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 770 Magnolia Blvd, New Caney, TX 77357 Phone: 281-713-8381 |